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Patient.—u Tim 19 maliv quit« orucutrut — t uo%r arAUíirut Durm.*

An English reaction tu the dùcovcrv of ether (From Punch, 1847)

(Reproduced by permission of Punch)

mail and through health food stores. In response, black-market manufacture of it has increased.

General Anesthetics

General anesthetics are powerful depressants used in surgery to make people insensible to pain. They are gases or volatile liquids administered by inhalation through masks over the face or tubes in the throat. Most are never seen outside operating rooms, but a few have been popular recreational drugs in the past, and one — nitrous oxide, or laughing gas — is still in common nonmedical use.

When breathed, general anesthetics enter the blood very rapidly, depressing brain function within seconds. The stronger ones quickly produce complete unconsciousness, a state that lasts as long as the drug is administered and for a short time afterward. Like all depressants, general anesthetics can kill by shutting down the respiratory center and other vital functions. During surgery, therefore, a specially trained doctor or technician must monitor the administration of the drugs and the moment-to-moment condition of the patient.

In low doses, general anesthetics produce changes in consciousness similar to alcohol and sedative-hypnotics, and for many years people have experimented with them to get high and to explore their minds.

Chloroform is one of the oldest drugs in this group. Since it is very toxic, it is no longer used. Years ago, people sometimes sniffed the fumes of liquid chloroform or swallowed small amounts in order to experience what disapproving critics called a "cheap drunk."

The era of surgical anesthesia began in 1846, when a dentist in Boston demonstrated that ether could safely render patients insensible to the pain of operations. Today ether (or, more correctly, diethyl ether) is still widely used to induce unconsciousness before surgery. Ether is a volatile liquid, easily administered to people through breathing masks. It has a strong chemical smell, and its main disadvantage is that its fumes make an extremely explosive mixture with air. Great care must be taken when ether is in use to prevent violent explosions from accidental sparks or flames. Another disadvantage of ether is that overdoses of it rapidly put people into deep comas and stop their respiration.

Prior to 1846, surgery was horribly painful; patients had to be tied down, and their screams could be heard far from operating

79 Depressants rooms. The discovery of ether anesthesia revolutionized surgery. Even before this event — as long ago as 1800 — ether was a well-known curiosity; many people played with it just to experience its unusual effects on consciousness.

Ether parties were popular throughout the 1800s. People would gather for the express purpose of sniffing the fumes or drinking tiny doses of the liquid. Used in this way, the effects came on in a few minutes and ended within a half-hour. As might be expected, the reactions were highly variable, just as with alcohol. But though there are reports of a few "ether addicts" from this period, most people probably tried the drug only once or twice out of curiosity. A few writers of the time claimed that ether gave them profound insights into the nature of reality and even mystical revelations.* Occasionally, people still experiment with ether, but if they like the effect it gives, they tend to look for other drugs that are less toxic, don't smell as bad, and won't blow up so easily.

Nitrous oxide is such a drug. A gas with only a faint odor, it is relatively nontoxic, and also nonflammable — although it will support combustion the way oxygen does and should be kept away from flames. Discovered in the late 1700s, nitrous oxide was quickly found to produce interesting changes in consciousness, as well as insensitivity to pain. Oddly enough, no one thought to use it in surgery until after the demonstration of ether anesthesia.

Nitrous oxide is a weaker drug than ether and the other general anesthetics, not producing complete loss of consciousness or anesthesia deep enough for major surgery. Nor is it so strong as to stop respiration. It is often used by itself in dentistry and minor surgery. In addition, many hospital anesthesiologists like to begin operations by having patients breathe nitrous oxide, then shift to ether and stronger drugs when the patients become totally relaxed and semiconscious.

People have been experimenting with nitrous oxide as a curiosity for the past two hundred years. Its effects, which come on within seconds, last as long as the gas is breathed, then disappear suddenly when it is stopped. Artists, writers, and philosophers have breathed nitrous oxide over and over in pursuit of elusive insights — revelations that seem overpowering under the influence of the gas, but which evaporate as soon as normal conscious-ness returns. When the English poet laureate Robert Southey tried the gas at a nitrous oxide party in London in the 1790s, he corn-

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